PL-15-387I(
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-228774 Permit Number: PL -2-15-387
Scheduled Inspection Date: April 08, 2015 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: TRAVELS & RENTALS CORP, TRAVELS Work Classification: Septic
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Job Address: 37 NW 108 Street
Miami Shores, FL 33168- Phone Number (305)538-8105
Parcel Number 1121360110290
Project: <NONE>
Contractor: MR C'S PLUMBING & SEPTIC INC Phone: (305)651-7859
sunaing uepanment comments
INSTALL SEPTIC TANK AND DRAIN FIELD
Passed
Failed
Correction
Needed
Re -Inspection
Fee
t
t
No Additional Inspections can be scheduled until
re -inspection fee is paid.
INSPECTOR COMMENTS False
Inspector Comments
HRS ON FILE
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April 07, 2016 For Inspections please call: (305)762-4949 Page 10 of 41
Miami Shores Village ''-�"
Building Department i
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 9
BUILDING Master Permit Nof;)(-_ %S_°
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 37 IVW ipS�S#
City: Miami Shores County: Miami Dade zip: 3316Y
Folio/Parcel#: 11 °1136 Ol 1 O a_cto Is the Building Historically Designated: Yes NO -
Occupancy Type: Load: Construction Type: _Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): i6k6ti �i At Phone#: 3oq J91 /oO*,
Address: 3? NW l0K S#
,.fl
City: ) c&'.; A'-ru State: F -e- Zip: b
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Mr �1S t lUl l+a JD[ Phone#:
Address: "/�l y302 &4j err
City: Iy,—' /� . / State: jG� zip: 7-7/6 y
Qualifier Name: K�6�0 ��C k Phone#: 164V Wfl
State Certification or Registration M IV od%rsol Certificate of Competency M
DESIGNER: Architect/Engineer: Phone#:
Address: ooa City: State: Zip:
Value of Work for this Permit: $Z Square/Linear Footage of Work: adv X"
Type of Work: ElAddition ❑( / Alteration ❑/New / lG(/ [ Repair/Replace -1 Demolition
Description of Work: 1R�i '.� 'An� ? some �.1�L'
Specify color of color thru tile:.
Submittal FeAk
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews
(Revised02/24/2014)
CCF $ CO/CC $
DBPR $
Notary $,
Double Fee $
Bond $
c)
TOTAL FEE NOW DUE $
�-�2- Es
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 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
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
fol first inspection which occurs seven (7) days after the building permit is issued in the absence of such posted notice, the
,inspection of be approved and a reinspection fee will be charged.
OWNER or
The foregoing instrument was acknowledged beforei/i a this
_2010C day of Wo y , 20 ly . by
6JMI& who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC: 6���
Sign:
Print-
m
Seal: KEPviBLE kTTRICK
Notary Public - State of Florida
My Comm. Expires Sep 19, 2017
Commission # FF 055732
APPROVED BY
C,
(Revised02/24/2014)
as
Signature
Isle] 011i:7dy(e]:1
The foregoing instrument was acknowledged before me this
20 day of g(u , 20 I- • by
16!^?iYV1IS14– h.>P4y_(45, 4ho is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Print:
,at►nr �'••, SHERYL A MENOES
Seal: =•?;• a`�= Notary Public -State of Florida
Comm. Expires Oct 23. 2018
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COM
M1138100 0 # FF 138597BMW ��O7,i io��•�
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'7-5 Plans Examiner
Structural Review
as
Zoning
Clerk
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STATE OF FLORIDA �!JPI:���" ° " PERMIT #: 18 -SC -1S87246
DEPARTMENT OF HEALTH APPLICATION #: AP1176266
ONSITE SEWAGE TREATMENT AND DISPOSAL DATE PAID:
SYSTEM
FEE PAID:
CONSTRUCTION PERMIT
RECEIPT #:
DOCUMENT #: PR964463
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Maria Diaz (Travel & Rentals)
PROPERTY ADDRESS: 37 NW 108 St Miami, FL 33168
LOT: 13 BLOCK: 214 SUBDIVISION: Dunnings Miami Shores
PROPERTY ID #: 11-2136-011-0290 [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 D AND SPECIFICATIONS
T [ 900 7 LONS / GPD new septic tank CAPACITY
A [ 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 ]QUARE FEET new bed confiq. drainfield SYSTEM
--!!
R [ '] SQUARE FEET SYSTEM
A TYPE SYSTEM: [X] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [ ] TRENCH [g] BED [ ]
N
F LOCATION OF BENCHMARK: FFE: 12.1' NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 7.20 ][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 57.24][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 62.00] INCHES
0 1. -Install a 900 gal min. septic tank with an approved filter.
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.
R (Comments Continued on Page 2.)
SPECIFICATIONS BY:\ 1 MW C"s
APPROVED BY:
DATE ISSUED: 02/17/2015
TITLE:
TITLE• Engineering Specialist II
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
Dade CHD
EXPIRATION DATE: 05/18/2015
v 1.1.4 AP1176266 SE951230
Page 1 of 3
' nocUMxT #: PR964463
-Invert elevation of drainfield to be no less than 7.83' NGVD.
-Bottom of drainfield elevation to be no less than 7.33' NGVD.
-This permit includes the abandonment of the existing septic tank.
ie system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of
)0 gpd.
-IIS PERMIT IS NOT FOR ANY ADDITIONS.