PL-14-908Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-211847 Permit Number: PL -5-14-908
Scheduled Inspection Date: November 05, 2014
Inspector: Diaz, Osvaldo
Owner: Vidal, Veruchska
Job Address: 1225 NE 91 Terrace
Miami Shores, FL 33138 -
Project: <NONE>
Contractor: STATEWIDE SEPTIC CONNECTIONS
comments
1:7d:JI_Ty:87OT-1N131:ice
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Septic
Phone Number
Parcel Number 1132050010240
INSPECTOR COMMENTS False
Phone: (954)963-0082
November 04, 2014 For Inspections please call: (305)762.4949 Page 6 of 31
Inspector Comments
Passed
HRS IN FILE
Failed
Ce
Correction
Needed
❑
Re -Inspection ❑
Fee
No Additional Inspections can
be scheduled until
re -inspection fee is paid.
November 04, 2014 For Inspections please call: (305)762.4949 Page 6 of 31
h
BUILDING
Miami Shores Village
a r
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
PERMIT APPLICATION
Master Permit No.
Sub Permit No'
R'z "Vp
MAY 0 2014
BY:. �L
FBC 20 P
❑BUILDING
❑ ELECTRIC
❑ ROOFING
❑ REVISION
❑ EXTENSION
❑RENEWAL
PLUMBING
❑ MECHANICAL
❑PUBLICWORKS
[:]CHANGE
CONTRACTOR
[:]CANCELLATION
❑ SHOP
DRAWINGS
JOB ADDRESS: lag �, /V & q1 Tf'rK
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: I `° 15w 5-- o 01 0 ` �t 0 Is the Building Historically Designated: Yes NO _
Occupancy Type: Load: Construction Type: ��Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): V i 00 ! V e iC ��� S Phone#:
Address: 12,2,,S kC— 91 TOY'
City: K A C na i ;S 40 0 WJ State Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: S- eu' C?q' 5 "C'6m f'ns (n c Phone#: 3d5 -Cj0
Address: I2,G 4-o NW « 6 *I
Qualifier Name: - 1 f_,red 94 `'_)'-/ 1 0
State Certification or Registration #:6'l l 2:% Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit:
City:
dC�
State: Zip:
Footage of Work: 2_&V
Type of Work: ❑ Addition
❑ Alteration
❑ New
Repair/Replace ❑ Demolition
Description of Work:
R< R
( ci Cie, .)
Specific color of color thru tile:
Submittal Fee $ Permit Fee $ d / 50 CCF $ CO/CC $
Scanning Fee $
Notary
Radon Fee $
Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $ - `v'0
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 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.
�jgnature 1,�� %, Signature t
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this
this day of M 20 (t by
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: fc: J13 Jo rn o F ro
My Commission Expires:
APPROVED
TF
EtfsA J SOLOMON
BION # FF -W935
�Y COMMIB 2015
Plans Examiner
The foregoing instrument was acknowledged before me Is
day of . 201 byTw`i--�, tx S
who is p a y n to a or who has produced
as
take an oath.
NOTARY PUBLI ��``���s
Sign:
Print:
My Commission Expires//11iiiis11�```��`�`
Zoning
Structural Review Clerk
(Revised02/24/2014)(Revised 5/2/2012)(Revised 3/12/2012) )(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007)
VIP Ar -A,
�n"t"lVi'!-k3D.`AIJE ,
PERMIT # :13 -SC -1535291
STATE OF FLORIDA APPLICATION #: AP1144799
DEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE Pte:
CONSTRUCTION PERMIT
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Veruchska Vidal
PROPERTY ADDRESS: 1225 NE 91 Ter Miami, FL 33138
RECEIPT #:
Docummw #: PR937825
LOT: 28, 29 BLOCK: 1 SUBDIVISION: Watersedge
PROPERTY ID #: 11-3205-001-0240 [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 ] GALLONS / GPD Existinq septic tank CAPACITY
A [ 0 ] GALLONS / GPD CAPACITY
N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ 225 ] GALLONS DOSING TANK CAPACITY 150.00 ]GALLONS @[ 6 ]DOSES PER 24 HRS #Pumps [ 1 ]
D [ 225 ] SQUARE FEET Trench configuration drain SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [X] STANDARD [ ] FILLED [ ] MOUND
I CONFIGURATION: [X] TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: FFE 6.5' NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 20.40][ INCHES FT I ABOVEBELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 36.40][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
L
LkX
O
T
H
E
R
li+++ A fiWUixn:u: L "1.00 ] INCHES EXCAVATION REQUIRED: [ 27.60 ] INCHES
1. -Existing 900 gal. septic tank, certified by "Statewide Septic Connections Inc." on. 4/23/2014 to remain.
2. -Install 225 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.
(Comments Continued on Page 2.)
SPECIFICATIONS .BY: Ter sa J Solomon TITLE: Master Septic Tank Contractor
APPROVED BY: TITLE: Engineering Specialist II Dade CHD
Betsy Lange-01mino
DATE ISSUED: 04/28/2014 EXPIRATION DATE: 07/27/2014
DH 4016, 08/09 (Obsoletes all previous editions which may
Incorporated: 64E-6.003, FAC
PaQe., 1: o
iJ 0' i P;° i rrii t'J t r.< %1f i ,:: r,� ✓
._an t ( K t•�. i .; Fr
v 1.1.4 "1144799 9 $E927067
i•i::n
comr'ilre t!?+(Q rc'.'_tdls t; Vle n_ri,"inal
Sia: ,, .,?... ... .. .. :. •1'. :`l. �\ rC i:1::^?C>: ":�r� f 'c: %y h! tc a--,:`_• ssed
DOCUMNT #: PR937825
vert elevation of drainfleld to be no less than 4.00' NGVD.
ottom of drainfleld elevation to be no less than 3.5' NGVD.
system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of
9pd•
i PERMIT IS NOT FOR ANY ADDITIONS.
.,
DEPARTMENT
OF HEALTH
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTR ICTPF 13MI T
Permit Applical on N!-jrnbe
PA},T IE -SITE PLAN--------__ —
Scare: Each block represents 5 feet and inch = 50 feet.
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71
Sito Plan submitted by:
P{ao Approved
Ry -
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I
J(rr(a`Eture -_
Not Approved
lot
Date
C-ounty Health Departm ;
ALL CHANGES MUST BE APPROVED BY TIHE COUNTY HEALTH DEPARTMEINT
N 40"5. !Ot^}> {R y�lar�� i Ifla-ti �vrm •".3 5 v:inich may used)
S,o.: lwrz ar: 5744 CK2 4035.63
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