PL-15-631Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number. INSP-230737 Permit Number: PL -3-15-631
Scheduled Inspection Date: April 07, 2015 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: , B&L REALTY HOLDINGS LLC Work Classification: Drainfield
Job Address: 170 NW/ 97 Street
Miami Shores, FL 33150 -
Project: <NONE>
Contractor: MR C'S PLUMBING & SEPTIC INC
Building Department Comments
DRAIN FILE D
Phone Number
Parcel Number 1131010250030
INSPECTOR COMMENTS False
nspector Comments
Phone: (305)651-7859
Passed I ' HRS IN FILE
�D
Failed
Correction
Needed ,1C i. l
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid
April 06, 2016 For Inspections please call: (305)762.4949 Page 27 of 63
Project Address Parcel Number Applicant
170 NW 97 Street 1131010250030
Miami Shores, FL 33150- Block: Lot: B&L REALTY HOLDINGS LLC
owner mrormation Address Phone Cell
B$L REALTY HOLDINGS LLC 395 NE 97 Street
F
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
MR C'S PLUMBING & SEPTIC INC (305)651-7859
Type of Work:
Type of Piping:
Additional Info:
Bond Return :
Classification: Residential Scanning: 3
Fees Due
Miami Shores Village
CCF
10050 N.E. 2nd Avenue NW
DBPR Fee
Miami Shores, FL 33138-0000
DCA Fee
Phone: (305)795-2204
Project Address Parcel Number Applicant
170 NW 97 Street 1131010250030
Miami Shores, FL 33150- Block: Lot: B&L REALTY HOLDINGS LLC
owner mrormation Address Phone Cell
B$L REALTY HOLDINGS LLC 395 NE 97 Street
F
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
MR C'S PLUMBING & SEPTIC INC (305)651-7859
Type of Work:
Type of Piping:
Additional Info:
Bond Return :
Classification: Residential Scanning: 3
Fees Due
Amount
CCF
$1.20
DBPR Fee
$2.25
DCA Fee
$2.25
Education Surcharge
$0.40
Permit Fee
$150.00
Scanning Fee
$9.00
Technology Fee
$1.60
Total:
$166.70
Valuation: $ 1,800.00
Total Sq Feet: 300
Pay Date Pav Type Amt Paid Amt Due
Invoice # PL -3-15-54879
03/26/2015 Check#:2709
$ 166.70 $ 0.00
Available Inspections:
Inspection Type:
HRS Approval
Final
Review Plumbing
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS 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. Futhermore, I authorize the above-named contractor to do the work stated.
March 26, 2015
Ignature:Owner / Applicant / Contractor
Building Department Copy
March 26, 2015 1
Miami Shores Village
Building Department MAR 20 2015
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
BUILDING Master Permit No.���_�
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
OPLUMBING [:]MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 110 W TI 4
City: Miami Shores County Miami Dade zip:
Folio/Parcel#: I l Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): 7J L KQ�(�zj Phone#: V WWI
Address: Stu,) AJW a &w -
City: State: Zip: 3 J S a
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Mr C's Plumbing and Septic Phone#: 305-651-7859
Address: 19932 NW 2 Ave
City: Miami State: FL Zip: 33169
Qualifier Name: Kemble Ettrick Phone#: 305-651-7859
State Certification or Registration #: SR061536 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: �i City: State Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work: 300
Type of Work: ❑ Addition ❑ Alteration ❑ New 0 Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee $ Permit Fee $b _r CCF $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $ _
(Revised02/24/2014)
DBPR $
CO/CC $
Notary
Double Fee $ 1 .p
Bond$
TOTAL FEE NOW DUE $ � C
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
for the inspection which occurs seven (7) days after the building permit is issued. in the abse ce of such posted notice, the
inspectiorn� I of be approved and a reinspection fee will be charged.
i
Signature Signature
1'OVIIER or AGENT
Zvoing instrur ent waas acknowledged before me this
tnday of ��, 20 i5 by
U' `-C-VL kyL- S , who is rsonally known
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
CONTRACTOR
The foregoing instrument was acknowledged before me this
a,,AA
O day of Y�11h>1Cl/, 20 by
who is personally known to
as me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
L
Sign: rii. �,s6"�'°� /G r Sign:_
I/i�►i Print
Print: e.�r1
Seal: pONNI Seal:
ANN BLANK
MY COMMISSION #FF158014
'?o EXPIRES O
ctober 1, 2
PI�PIda
S6NiCe.Co
APPROVED BY :?s% f 5 Plans Examiner
Structural Review
(Revised02/24/2014)
Notary Public - State of Florida
My Comm. Expires Oct 23, 2016
Commlaslon # FF 138597
as
Zoning
Clerk
r �•
•"udaaRlt.:a'a8.., y,•� •.. aY a= .p 5d`i,. Ali
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
PERMIT #:13 -SC -1593646
APPLICATION #: AP 1180511
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR968122
CONSTRUCTION PERMIT FOR: OSTDS Repair
`'
APPLICANT: (B & L Realty)
Pa 3t�sa 8 -BBQ :t @86 VISI—V G3 Pi N i l
PROPERTY ADDRESS: 170 NW 97 St Miami, FL 33150
LOT: 3 BLOCK: 3 SUBDIVISION:
PROPERTY ID #: 11-3101-025-0030
[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 1 GALLONS / GPD Septic (Existing) CAPACITY
A [ 0 1 GALLONS / GPD CAPACITY
N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS O[ ]DOSES PER 24 HRS #Pumps [ ]
D [ ""z3001 QUARE FEET Bed Confiquration Drainfie SYSTEM
R [ SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ I MOUND [ ]
I CONFIGURATION: [ I TRENCH [g] BED [ ]
N
F LOCATION OF BENCHMARK: FFE 13.3' NGVD
I ELEVATION OF PROPOSED SYSTEM SITE ( 22.80)[ INCHE3 FT ][ ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 72.80]) INCHES T FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 62.00] INCHES
"*THIS PERMIT IS NOT FOR ADDITIONS -
0 1. -Existing 900 gal. septic tank, certified by "Mr. C's Plumbing + Septic on 03/16/15" to remain.
T 2. -Install 300 sf of drainfield in bed configuration.
H 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.
E 5. -Invert elevation of drainfield to be no less than 7.73' NGVD.
6. -Bottom of drainfield elevati o aIno less than 7.23' NGVD.
R 11
BY:
APPROVED BY:
TITLE:
TITLE: Engineering Specialist II
DATE ISSUED: 03Th9fff15 EXPIRATION DATE:
DH 4016, 08/09 (Obsoletes all pwevious editions which kay -not be a6d)"-'`
Incorporated: 64E-6.003, EAC
AP1180511` "sE$54'660
Dade CHD
06/17/2015
Page 1 of 3
PR]
"
<sION OF �> linviroonmIental Health
Florida Health ,
0"IF" Miami -Dade County
OSTDS/Well Division
VIq IM* %Immi. FLI.117c
Date
,Address
2 !Y�T n �w
,omments.
Sent from my Whone � --�� /
2