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PL-14-2765Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-225453 Permit Number: PL -12-14-2765 Scheduled Inspection Date: January 06, 2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: Kovac, Giselle Work Classification: Septic Job Address: 290 NE 98 Street Miami Shores, FL 33138 - Project: <NONE> Phone Number 828 230-5395 Parcel Number 1132060134150 Contractor: MR C'S PLUMBING & SEPTIC INC Phone: (305)651-7859 Building Department Comments SEPTIC TANK AND DRAIN FIELD INSTALLATION. intractio Passed comments INSPECTOR COMMENTS False Inspector Comments Passed HRS ON FILE Failed (f j) Correction Needed Re -Inspection ❑ Fee,"---,� No Additional Inspections can be scheduled until re -inspection fee is paid. January 05, 2015 For Inspections please call: (305)762-4949 Page 28 of 45 BUILDING PERMIT APPLICATION ❑ BUILDING ❑ ELECTRIC Miami Shores Village Building Department DEC 2014 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972] INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20�- Master Permit No � L:. k �4 t_ Sub Permit No. ❑ ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL y PLUMBING [] MECHANICAL F-1 PUBLIC WORKS [:]CHANG€ OF ❑ CANCELLATION [:]SHOP CONTRACTOR DRAWINGS JOB ADDRESS: c�M) ISG /C J 5T_ City: Miami Shores County: Miami Dade Zip: t; Folio/Parcel#: Is the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: I FFE OWNER: Name (Fee Simple Titleholder): Lra (moi r Phone#:_i Address: CP?o Nlc 90 S7— City: P{AW Sti)2:#-'S State: t�(� Zip: 3 313 ?) Tenant/Lessee Name: � Phone#: Email: 13LU v ICC71/AC 6 C �Y A [ �_ , c6Yyi CONTRACTOR: Company Name:_A 1l5 b(/&br ✓ z Phone#: Address: 6 ( 4/4) ak'A,-c It City: Zip: 33Z � 9 Qualifier Name: ri�.r✓,I�C fiiI77lGlc_ Phone#: State Certification or Registration #: 5 i? 6 61 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Aririresc � City' State: Zip: Value of Work for this Permit: $ Type of Work: ❑ Addition Description of Work: ❑ Alteration , i,A/ ,are/Linear Footage of Work: Soo ❑ New>I<epair/Replace ❑ Demolition Specify Submittal Scanning Fee $ Technology Fee $ Structural ReViews $ (Rev1sed02/24/2024) Y Radon Fee $ Training/Education Fee $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ - �J *3onding Company's Name (if applicable) Bonding Company's Address City Mortgage Lender's Name (if applicable) Mortgage Lender's Address City 4 State 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, 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 x �'°7 'RESULT IN YOUR PAYING TWICE, -FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBt-AftlWANCING, CONSULT. ITIVYPUR LENDV 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. rIW Signatu e ASignature GENT CONTRACTOR The foregoing instrument was acknowledged before me this day of 120 by f_ who is personally known to me or who has produced as i&ntification and who did take an oath. Jr NOTARY PUBLIC: _ Print: -� - KEMBLE ETTRICK 49, State ol Florida Seal: ' S My Comm. Expires Sep 19, 2017 ';9, P.� Commission # FF055732 Bonded Through National Notary Assn. The foregoing instrument was acknowledged before me this 1� day of ��� r/�S . 20 by who is personal) known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: i Seal: g Notary Public - stmt o1 F"a z' . • 1 My Comm. Expires Oct 23, 2016 Commission # FF 136597 " Bonded Through National NOL" Asm APPROVED BY /,-�/Z-/; •1)1" Plans Examiner Structural Review (Revised02/24/2014) Zoning Clerk ErAtR i, aaa STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT- Giselle Kovac PERMIT #:13 -SC -1574921 APPLICATION #:AP1168496 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR958332 PROPERTY ADDRESS: 290 NE 98 St Miami, FL 33138 LOT: 1, 2 BLOCK: 31 SUBDIVISION: Miami Shores PROPERTY ID #: 11-3206-013-4150 [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 SPECIFICATIONS , T [ 1,200 GALLONS / GPD new septic tank CAPACITY A ( 0 ] GALLONS / GPD CAPACITY N [ 0 1 GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY ( ]GALLONS @[ ]DOSES PER 24 HRS #Pumps ( ] D [ 300 YSQUARE FEET new bed config. drainfield SYSTEM R [ O ] SQUARE FEET SYSTEM A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH [x] BED [ ] N F LOCATION OF BENCHMARK: FFE 10.9' NGVD I ELEVATION OF PROPOSED SYSTEM SITE [ 8.40 ][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 58.44][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [,62.00] INCHES 1. -Install a 1200 gal min. septic tank with an approved filter. 0 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 300 sf of drainfield in bed configuration. 4. -Install 12" 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 or drain trench. (Comments Continued on Page 2.) R SPECIFICATIONS BY: M C\s Plb Sept APPROVED BY: DATE ISSUED: 4 TITLE: TITLE: Engineering Specialist II Dade CHD EXPIRATION DATE: 03/16/2015 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 AP1I6R49e; .>us4552�7 DOCUMENT #: PR958332 6. -Invert elevation of drainfield to be no less than 6.53' NGVD. T -Bottom of drainfield elevation to be no less than 6.03' NGVD. 8. -This permit includes the abandonment of the existing septic tank. The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of 460 gpd. THIS PERMIT IS NOT FOR ANY ADDITIONS. T STATE OF FLORIDA APPLICATION # AP1168496 DEPARTMENT OF HEALTH PERMIT # 13 -SC -1574921 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT # SE945620 SITE EVALUATION AND SYSTEM SPECIFICATION APPLICANT: Giselle Kovac CONTRACTOR / AGENT: MrC LOT: 1.2 _ BLOCK: 31 SUBDIVISION: Miami Shores ID#: 11-3206-013-4150 TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: [X]YES [ ]NO NET USABLE AREA AVAILABLE: 0.27 ACRES TOTAL ESTIMATED SEWAGE FLOW: 460 GALLONS PER DAY [ RESIDENCES-TABLEI / OTHER -TABLE 2 ] AUTHORIZED SEWAGE FLOW: 674.99 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE] UNOBSTRUCTED AREA AVAILABLE: 450.00 SQFT UNOBSTRUCTED AREA REQUIRED: 450.00 SQFT BENCHMARK/REFERENCE POINT LOCATION: FFE 10.9' NGVD ELEVATION OF PROPOSED SYSTEM SITE 8.40 [[INCHES]/ FT ] [ ABOVE / BELOW ] BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: FT DITCHES/SWALES: FT NORMALLY WET: [ ]YES [ ]NO WELLS: PUBLIC: _FT LIMITED USE: FT PRIVATE: FT NON -POTABLE: FT BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 30 FT SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]NO] 10 YEAR FLOOD ELEVATION FOR SITE: FT[ MSL /NGVD ] SITE ELEVATION: 10.20 FT [ MSL /NGVD SOIL PROFILE INFORMATION SITE 1 SOIL PROFILE INFORMATION SITE 2 USDA SOIL SERIES: Munsell #/Color Urban land Texture Depth 10YR 3/1 Sand 0 To 8 10YR 5/4 Sand 8 To 25 10YR 5/4 Oolitic Limestone 25 To 72 USDA SOIL SERIES: Munsell #/Color Urban land Texture Depth 10YR 3/1 Sand 0 To 8 10YR 5/4 Sand 8 To 25 10YR 5/4 Oolitic Limestone 25 To 72 OBSERVED WATER TABLE: INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 86 INCHES [ ABOVE /[[HE] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [ ]YES [X]NO DEPTH: INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Replacement 4-FS/0.60; DEPTH OF EXCAVATION: 62 INCHES DRAINFIELD CONFIGURATION: [ ] TRENCH [XI BED [ ] OTHER (SPECIFY) REMARKS/ADDIT1UNAL CRITERIA . SITE EVALUATED BY: DATE: Mr C's Plb Sept, (Title: ) (Mr C's Plb Septic) DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC 12/08/2014 Page 3 of 4 AP1168496 E101574921 v 1.0.2 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.