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PL-14-378Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number. INSP-210252 Permit Number PL -2-14-378 Scheduled Inspection Date: November 18, 2014 Permit Type: Plumbing - Residential Inspector. Diaz, Osvaldo Inspection Type: Final Owner: ADAM SHEPARD, ALISON ANTROBUS Job Address: 295 NE 95 Street Miami Shores, FL 33138 - Project: <NONE> Work Classification: Septic Phone Number Parcel Number 1132060133970 Contractor. STATEWIDE SEPTIC CONNECTIONS Phone: (954)963-0082 comments INSTALL 667 BED DRAIN FILED INSTALL 300 GALLON mrracuo rassea comments CLOSING TANK WITH 1/2 PUMP FLOAT ALARM INSPECTOR COMMENTS False November 17, 2014 For Inspections please call: (305)762-4949 Page 6 of 46 Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-208072. SOD PENDING HOME UNDER CONSTRUCTION Failed Correction Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee Is paid November 17, 2014 For Inspections please call: (305)762-4949 Page 6 of 46 �rSc�cbn u f"1'� ( I Miami Shores Village Building Department I I 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 V INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Type: PLUMBING Permit No. FEB 2-.8 2014 Master Permit No. R l A/ -- 2 ZZ - JOB JOB ADDRESS: 2"15 rvE 1 S Qt City: Miami Shores County: Miami Dade Zip: -x.%31-38 Folio/Parcel#: I(- 3 Z. O G• of 3• !qq 1 O Is the Building Historically Designated: Yes NO ✓ Flood Zone: OWNER: Name (Fee Simple Titleholder): ASI iSO n Atim+tao bol Phone#: Address: as jy%e) City: State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: S GtiI�� hC Phone# 56S_''ro [-66x Address: po 80 K , ; .mac d Y � q 0 City: « WVO� —State: 1 ` s _:. Zip: a 08 3 Qualifier Name: U n OM a State Certification or Registration #: d(A 091 1 Z61, Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer.. Phone#: Value of Work for this Permit: $ 3600 y Square/Linear Footage of or :: �7 Type of Work: ❑Address Description of Work: Alteration ❑New ®Demolition W� Submittal Fee $ _!S_Q , CD Q Permit Fee $ Jf -36c"" CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Bond Technology Fee $ TOTAL FEE NOW DUE' 3.9n C5 rd Bonding Company's Name _(if applicable) Bonding Compny'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 gccpratemd that all work will be done in compliance with all applicable laws regulating construction and zoning. C7 �; ,, _ I 66WART4 ',%*TO OWNER: YOUR FAILURE T9. ,RECORD A t NOTICE OF COMMENCEMENT MAY RESULT 1�1�1 hA TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICF;0F;@0tNCEM9_NT:P 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. e c f Signatbre ' d Signature Owner or Agent ; , _ Conntaractos The foregoing insti&';ont was acknowledged before me this -ZPP The foregoing instrutnenvwa�_a�knovddged before me this day of F{(j , 2d �f,- by int D F -O ^ ArV V+rof dJl', day of 20 by , who is p ally known is me or who has produced who persona orpersonally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: V ` QL Print: Tthe�'� b O g _9 'r My Commission Expires:1-11 _,4, APPROVED BY as identification and who did take an oath. NOTARY PUBLIC: s �M©M MISSION # EE13193� :0tes irdesBdra�Itfif,9AnY�'e9e�e Plans Examiner Structural Review (Revised3/12)2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Sign: ygComniission Expires: a ''1 6. Zoning Clerk STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: OSTDS New APPLICANT: Alison Antrobus PROPERTY ADDRESS: 295 NE 95 St Miami, FL 33138 LOT: 23 24 BLOCK: 29 SUBDIVISION: PROPERTY ID #: 11-3206-013-3970 PERMIT #:13 -SC -1517701 APPLICATION #:AP1133647 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR931329 [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 [ 1,050 ] GALLONS / GPD Septic CAPACITY A I ] GALLONS / GPD N/A tCAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ 300 ] GALLONS DOSING TANK CAPACITY [67.00 ]GALLONS @[ 6 ]DOSES PER 24 HRS #Pumps [ 1 ] D [ 667 ] SQUARE FEET R [ ] SQUARE FEET A TYPE SYSTEM: [X] I CONFIGURATION: [ ] N SYSTEM N/A SYSTEM STANDARD [ ] FILLED [ ] MOUND TRENCH [X] BED [ ] F LOCATION OF BENCHMARK: C/L NE 3 Ave & 95 Street = 10.08' NGVD I ELEVATION OF PROPOSED SYSTEM SITE [ 4.44 ][INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 34.44][CMEg FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 88.00] INCHES 1. -Existing 900 gal. septic tank, certified by "Statewide Septic on 01/05/14" to remain. O 2. -The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance T with s. 64E -6.013(3)(f), FAC. H 3. -Install 667 sf of drainfield in bed configuration. 4. -Install 42" of slightly limited soil at the bottom of the drainfield. E 5. -Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bed. 6. -Invert elevation of drain/fl to be no less than 6.38' NGVD. R SPECIFICATIONS BY: I t"a1. Solomon _ TITLE, Master Septic Tank Contractor APPROVED BY: 1 \/ �� TITLE: Engineering Specialist II r7iaOle P Gumbo DATE ISSUED: 02/27/2014 EXPITZFFfA N,DATE: DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC v y • 1 •AThbWAFractor (or designee) �.zw#zod to perform a soil boring adjacent to the drainfield excavation at the time of final inspection. Prior to Final Approval, the DOH inspector shall witness the soil boring and compare the results to the original site evaluation submitted. A - rpinspection fee will be assessed if the contractor is not at the jobsite at .,ne arranged time. Dade CHD 08/27/2015 Page 1 of 3 DOCUMENT #: PR931329 .-Bottom of drainfield elevation to be no less than 5.88' NGVD. .-This permit includes the abandonment of the existing septic tank. 'he system is sized for 4 bedrooms with a maximum occupancy of 8 persons (2 per bedroom), for a total estimated flow of 00 gpd. lerforming Lift Dosing. lumps must be certified as suitable for distributing sewage effluent. 'he licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s. 4E -6.013(3)(f), FAC.