PL-14-51300145.
ixlN
BUILDING
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.494
PERMIT APPLICATION
Permit Type: PLUMBING
JOB ADDRESS:
Permit No.
Master Permit No. /P/
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO
Zone:
OWNER: Name (Fee Simple Titleholder):A4,A -11 Phone #:
Address: S-51 nr_ l 6-s- bt,
City: &1&4*) State: 1VI
Tenant/Lessee Name: Phone #:
Email:
CONTRACTOR: Company Name: �; q 4t' Phonek a ff` W t
Address: •oheo taicill
City: Im _ State:
Qualifier Name: Phone #: c3
State Certification or Registration #: -+6i to- Certificate of Competency #:
Contact Phone #:6 16 .1% Email Address: 5714& C
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ 01 ti5o Square/Linear Foo f Work: 3 PD
Type. of Work: ❑Address ❑Alteration ❑New f�/Rvplace ❑Demolition
Description of Work:Q, a� G
Submittal Fee $ C9 Permit Fee $ X91G(J " CCF
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CO /CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $ s •�
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 construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certifled 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
O er or Agent
The foregoing instrument was acknowledged before me this
day ofll� —,20 `q,bY��t ,
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of PUM4 20 A, by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign: V94A49tCAk@&&AF 4 Sign:
Print: M'�I�l � 3p �0� 9 t Print: ,� 0���`130, ?0.1 -1:
CP %71
- cn
My Commission Expires: .
* My Commission Ex p ires:
iFFOOM ; �* sic I bed Jtr°=
X99 '.�i _ftWcte� a Q��
` �<
It�iNti1>>\
APPROVED BY j (i-/ Plans Examiner Zoning
Structural Review Clerk
(Revised3 /112012 )(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
. . t
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 209089
Scheduled Inspection Date: March 25, 2014
Inspector: Diaz, Osvaldo
Owner: MENDEZ, BENIGNO
Job Address: 551 NE 105 Street
Miami Shores, FL 33138 -
Project: <NONE>
Contractor: CHAPMAN SEPTIC SERVICE, INC.
Building Department Comments
Permit Number: PL -3 -14 -513
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Drainfield
Phone Number
Parcel Number
1122310140280
Phone: (305)815 -9901
ABANDON EXISTING TANK INSTALL 900 GALLON AND Infractio Passed Comments
300SQ. FT DRAIN FIELD I INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction; -
Needed
Re- inspection
Fee
No Additional Inspections can be scheduled until /
re- inspection fee is paid.
March 24, 2014 For Inspections please call: (305)762 -4949
Page 19 of 35
1
DIVISION OF
Environmental Health
�0 Florida Health
Miami -Dade County
Q0
� 11OSTDS/Well Division Q
4 805 SW 261" Street - Miami, FL 33175
Inspector Jo s eg i t ye_ r 9_oP_r Date 3 211/ZDL�
Address S.S ( N t O S alb _OSTDS # 3 3 D
Comments:
Signature
Master Septic Tank Contractor
CHARLES J CHAPMAN
471 BIG PINE ROAD
KEY LARGO FL 33037 -
CHAPMAN SEPTIC SERVICE, INC.
Business Authorization: SA0910574
SM0941167
Registration Expires on September 30, 2014
A
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
rlh�
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Benigno Mendez
PROPERTY ADDRESS: 551 NE 105 St Miami, FL 33138
LOT: 19 BLOCK: 10
PROPERTY ID #: 11- 2231 - 014 -0280
SUBDIVISION:
PERMIT #:13 -SC- 1520382
APPLICATION #: AP1135308
DATE PAID:
FEE PAID:
RECEIPT #:
DocUMENT #: PR929687
amd pl miami shores
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
361.0065, 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 ] GALLONS / GPD New Septic Tank CAPACITY
A [ 0 ] GALLONS / GPD CAPACITY
N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps
D [ 300 ] SQUARE FEET
R [ 0 ] SQUARE FEET
A TYPE SYSTEM: [X]
I CONFIGURATION: [ ]
N
bed configuration drainfiel SYSTEM
SYSTEM
STANDARD [ ] FILLED [ ] MOUND [ ]
TRENCH [x] BED [ ]
F LOCATION OF BENCHMARK: Top of bottom floor, 12.30' NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 18.00][ INCHE3 FT ][ABOVE BELOW BENCHMARK /REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 58.00 1 fi-N—c-Hisl FT ][ABOVE BELOW BENCHMARK /REFERENCE POINT
L
D r-
0
T
H
E
R
ANWulmij : L U.UU- J 1L4L;n b JS- &U&VA:X -LW V 2 %ZWU -LAz 7: L SL.UU J -L V1:t11'i.1.'
repair permit was wranted based on building information provided in the application by the contractor of 3 bedroom
with 1,542 sq.ft. of building area.
sewer line shall be permitted and inspected by the pertinent plumbing dept.
actor to verify the existing septic tank is properly abandoned before final approval.
in elevation of drainfield to be no less than 7.96' NGVD.
om of drainfield elevation to be no less than 7.46' NGVD.
all 12° of slightly limited soil under the bottom of drainfield.
SPECIFICATIONS BY: Charles J Chapman
APPROVED BY: TITLE:
Carlos M Icaza
DATE ISSUED: 02/12/2014
DH 4016, 06/09 ( di'9crrla8s `''als{iva��c�n8eir�� W may not be used)
Incorporated: �s; d iCii o [')e draiMe d LtxGavatf(',
tune tkt i���a, ar sl�ect,c,�. ' "or 1,, Final t'ipprov�fl,
inshemor sh, -dIE ��ir, °s'' i soil boring @rld ccff(N+a 08
results to the c:riginai siie e valu�;tic�n w�abmiCeci. /�,
ri;tion tee ifvil; l,e rsse.::yzFs it the conirao or is no-
r i -. e, ,�,'`,: 1j,,. a t oy. a,(ai)ge:t >+mc
TITLE: Master Septic Tank Contractor
EXPIRATION DATE:
SE919610
Dade CHD
05/13/2014
Page 1 of 3
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