PL-13-1387r
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Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL,
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 193898 Permit Number: PL -6-13 -1387
Scheduled Inspection Date: July 18, 2013 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Owner: GOME ,"LINA
Job Address: 10109 N MIAMI Avenue
Miami Shores, FL 33150-
Project: <NONE>
Contractor: A AARON SUPER ROOTER
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060131510
Phone: 305-944 -88$6
Building Department Comments
REPLACE DRAINFIELD
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections Can be scheduled until
re- inspection fee is paid.
Inspector Comments
HRS IN FILE
False
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Al) Building Department �Ufe� 18 2013
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 NoV�-,` 1-3 �1—
Permit Type: PLUMBING
JOB ADDRESS: (o I c)9 rQ Mb runt Ave,
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #: ""� A2 o ro ® I
Is the Building Historically Designated: Yes
NO e0 Flood Zone:
G OWNER: Name (Fee Simple Titleholder): G e) PA orn eZ' Phone #: 3 ®S° 527® 151 o
Address: i Cd
City: M s n 41 State: Zip: 3 31 S
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name: AQ rOn I-S ,/ P+e° Phone #: `30 4 4SS-6
Address: e.L) Z)e C-r
City: rn cle— _ State: Zip: 3 0
Qualifier Name: -T3�\ n '3
State Certification or Registration #:
Contact Phone #:
Address:
Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ '256o Square/Linear Footage of Work: ISO
Type of Work: LIAddress DAlteration ONew Repair/Replace ODemolition
Description of Work:
Submittal Fee $ Permit Fee $ CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Technology Fee $
TOTAL FEE NOW DUE $
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
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 construcyone brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded mencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit n the absence of such post ed notice, the
inspection will not be appr d a reinspection fee will be charged.
Signature Signature
caner or Agent Contractor
The foregoing instrument was acknowledged before me this 10 The foregoing instrument was acknowledged before me this I°®
day of L%e , 20 , by r nC1 &ornCZ day of +V- , 20 17 , by JV f1'° c ,
who is personally known to me or who has produced 9�r % V who is personally known to me or who has produced
U As identification and who did take an oath.
NOTARY PUBLIC:
c _ - as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: —Ferfu- Sc:) 0®
My Commission Expires: TF.RESA J SOLOMOM i My Commission
F59 ° _ MY COMMISSION # EE13EXPIRES November O8, 209 a 41 i
APPROVED BY - Plans Examiner
Structural Review
(Revised3 /12/2012 )(Revised 07 /10 /07)(Revised 06/10 /2009 )(Revised 3/15/09)
TrIRESA J SOLOM ®R'
MY COMMISSION # EE1319 3S
Zoning
Clerk
REPAIR
"" COMM LIW ow
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Margarita Mesa
PROPERTY ADDRESS: 10109 N Miami Ave Miami, FL 33138
LOT: 13,14 BLOCK: 11 SUBDIVISION
PROPERTY ID #: 11- 3206 - 013 -1510
PERMIT #: 13-SC-1478806
APPLICATION #:AP1110862
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR909464
Miami Shores Sec 1 Amd
[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 [ 600 1 GALLONS / GPD existing septic tank CAPACITY
A [ J GALLONS / GPD CAPACITY
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps
D [ 150 ] SQUARE FEET trench configuration drainf SYSTEM
R [ ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND I ]
I CONFIGURATION: [x] TRENCH 1 ] BED [ ]
6
F LOCATION OF BENCHMARK: FFE 12.6' NGVD
I ELEVATION OF PROPOSED SYSTEM SITE
1 16.8011 INCHES
FT ][ ABOVE BELOW BENCHMARK /REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE
[ 56.80][ INCHES
FT ][ABOVE BELOW BENCHMARK /REFERENCE POINT
L
D F
O
T
H
E
R
1L1, tiEQulmzu: L J INCHES EXCAVATION REQUIRED: ( 52,uu J INCHES
1.- Existing 600 gal. septic tank, certified by A Aaron Super Rooter on 06/11/2013 to remain.
2.- Install 150 sf of drainfield in trench configuration.
3.- Install 12" of slightly limited soil at the bottom of the drainfield.
4.- Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bed or drain trench
5. -Invert elevation of drainfield to be no less than 8.77' NGVD.
6. -Bottom of drainfield elevation to be no less than 8.27' NGVD.
System sized for 2 bedrooms with a maximum occupancy of 4 persons (2 per bedroom), for a total est. flow of 300gpd.
SPECIFICATIONS BY: JOHN J TUFFY TITLE:
APPROVED BY: ,�iy� QjiJ/� TITLE: Engineering Specialist II Dade CHD
Erlande Omisca
DATE ISSUED: 06/18/2013 EXPIRATION DATE: 09/16/2013
DH 4016, 08/09 (Obsoletes all previous editions which may not be usejdt, GU ^tr«Ci:,r (Or oes;gneE) ;, rggJ
Incorporated: 64E -6.003 FAC ;; q
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"TSN-ATE dr- FLORIDA
DEPARTMENT OF HEALTH 13
SYSTEM CONSTF JM i0M PEH-Mil'
APPLICATION FOR ONSITE SEWAPF
jVWjV41 Applicat on
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inch 50 feet.
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Not Approved
ALL CHANGES MUST BE APPROVED BY THE COUNTY F1 E A L*T I D E P A %RTNIENT