PL-15-1016I- lk
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (306)795-2204 Fax: (305)756-8972
Inspection Number: INSP-233625 Permit Number: hL-4-15-1016
Scheduled Inspection Date: May 12, 2015 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: PARDO, MARGARITA Mork Classification: Septic
Job Address: 29 NE 106 Street
Miami Shores, FL 33138- Phone Number 3051754-5864
Parcel Number 1121360060270
Project: <NONE>
Contractor: ALL PRO SEPTIC AND SEWER INC Phone: (305)635-3002
Builds
Comments
NEW SEPTIC TANK AND DRAINMELD
Inspector Comments
05/08/2015
HRS APPROVAL IN FILE.
Failed
Correction
Needed
Re -Inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid
�
�
May 11, 2015 For Inspections please call: (305)762-4949 Page 21 of 42
Project Address Parcel Number Applicant
29 NE 106 Street 1121360060270 MARGARITA PARDO
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
MARGARITA PARDO 29 NE 106 ST 3051754-5864
MIAMI SHORES FL 33138
Contractor(s) Phone Cell Phone
ALL PRO SEPTIC AND SEWER INC (305)635-3002
Type of Work: NEW SEPTIC TANK AND DRAINFIELD
Type of Piping:
Additional Info:
Bond Return :
Classification: Residential Scanning: 3
Fees Due
Miami Shores Village
Bond Type - Contractors Bond
10050 N.E. 2nd Avenue NE
CCF
Miami Shores, FL 33138-0000
DBPR Fee
Phone: (305)795-2204
Project Address Parcel Number Applicant
29 NE 106 Street 1121360060270 MARGARITA PARDO
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
MARGARITA PARDO 29 NE 106 ST 3051754-5864
MIAMI SHORES FL 33138
Contractor(s) Phone Cell Phone
ALL PRO SEPTIC AND SEWER INC (305)635-3002
Type of Work: NEW SEPTIC TANK AND DRAINFIELD
Type of Piping:
Additional Info:
Bond Return :
Classification: Residential Scanning: 3
Fees Due
Amount
Bond Type - Contractors Bond
$500.00
CCF
$4.20
DBPR Fee
$4.50
DCA Fee
$4.50
Education Surcharge
$1.40
Permit Fee
$300.00
Scanning Fee
$9.00
Technology Fee
$5.60
Total:
$829.20
Valuation: $ 6,300.00
Total Sq Feet: 225
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL -4-16-55369
04/30/2015 Check #: 010451 $ 779.20 $ 50.00
04/29/2015 Check #: 010446 $ 50.00 $ 0.00
Bond #: 2695
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-nameA contraptor to do the work stated.
Authorized Signature:
Applicant / Co4ftractor / Agent
30, 2015
Building Department Copy
April 30, 2015 1
Miami Shores Village APR
Building Department artment BY:
-----
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING Permit No.'t"L" t' 10 K)
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type: U ffl1NG -
OWNER: Name (Fee Simple Titleholder): k/ I L"li: Y lhl-d-c Phone#:
Address: AJ L, 0 6
City: M � �' State: PIS Zip: 3 y 3S'
Tenant/LesseeName: / 4ihtf. Phone#:
Email:
JOB ADDRESS: A_�
City: Miami Shores County: Miami Dade Zip: 3 % 3 1
Folio/Parcel#: I i o 13 6- ®. )�
Is the Building Historically Designated: Yes NO Flood Zone:
7
CONTRACTOR: Company Name: Phone#�� �� 3 .S -3v&
Address: � � � � A-)�'�' � ® '�`
City: my -41-57. o / a State: Zip: -3 31 Lf D
Qualifier Name: _ i ce` _ 1 ;ter �L' / g4j- Phone#: (3 C, r)
State Certification or Registration#: SAI -_0 9 I / 3-3 Certificate of Competency #:
Contact Phone#: (3 vs.) 6 ,3 1'_3 / rEmail Address: Z.�t� �mt� �� b e llsc,W�
DESIGNER: Architect/Engineer: t) L4- Phone#: 14 -
Value of Work for this Permit: $ (0 3 0 Square/Linear Footage of Work:
Type of Work: ❑Address DAlteration
Descriptioif of Work: lit -4 -AK -4-7- A-0 A -A
A-o�-
ONew gkepair/Replace ODemolition
EA
Submittal Fee $ Permit Fee $ 3(X . ;`f CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Technology Fee $
TOTAL FEE NOW DUE $
=F:� 14-k-11
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
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, BEATERS, 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 notb appr 1 v d and a reinspection fee will be charged.
Signature Signature
Owner or Agent Contractor 4k
The foregoing instrument was acknowledged befor me this Z` The fore oing instrument was acknowl ged befo me this!
day of r `, 2p 1��, by �l �1 r1 t� C4-Ckday of JL1 1 , 20 �by 1• �i � i(c�
who is personally known to me or who has producedo is personally kno to me or who has produced
fication and who did take an oath. as id tification and who di
NOTARY PUB I ': NOTARY P
IRENIA GUn i1 Floriea
��� 8tatc
PmblEatOhaB Feb 22.226
Sign: FIIiEZ Sign: , •i M Com n EE 18863
a u, • �y
Print: ��4Y ' ar Pub11c -own
of 2018 �1•l;;e �°�
Y P m er my Commm�on • EE 188832 My Commis xpires.
M Commission Ex fres
ti �_
APPROVED BY �1 °l Plans Examiner
Structural Review
(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
Zoning
Clerk
ADGENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT. MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING ELECTRICAL fjECHANICAL
q ,)c o 6 #rW4'T s f fir. 3 3t3P
ITEM
BATH TUB
UNIT FEE ITEM
SWITCH OUTLETS
UNIT FEE ITEM UNIT FEE
SPACE HEATERS
BIDET
LIGHT OUTLETS
CENTRAL MATING
BISliWASiER
I RECEPTACLES
A/C (WIND)
DISPOSAL
SERVICE TEMPORARY
A/C (CERMAI-)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE TANKS
LgWRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
Srw. POT/3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 If
TRANMTING ASSEMBLIES
SINK, SLOP
MOTORS OVER $- 10 If
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 If
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 FP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES-`
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
I
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER -REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY=WATER.
FIXTURES
SEPTIC TANK
I ANTENNA
RELAY
% TELEVISION OUTLETS
DRAINFIELD, 4- TILE/RES.
VIOLATION
PUMP S ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS)
GAS PIPING
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
CONSTRUCTION PERMIT FOR: OSTDS Repair.'.,
APPLICANT: Margarita Pardo
PROPERTY ADDRESS; 29 NE 106 St Miami, FL -33138
LOT: 11 BLOCK: 207 SUBDIVISION:
PROPERTY ID #: 11-2135.006-0270
PERMIT #:13-SC4 601083
APPLICATION #: AP1185332
DATE PAID:
FEE PAID:
RECEIPT #:
DOcubma #: PR972130
[SECTION, TORNSHIP, 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, ,FA.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 BERMIT, 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' iiPLICANT FROM COMPLIANCE WITH OTHER FEDERAL,
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPblENT OF THIS PROPERTY.
SYSTEM DESIGN AND SPECIFICATIONS
T I 900 _ GAI T "-NS / GPD new septic tank CAPACITY
A I 0 ] GALLONS/ GPD CAPACITY
N I 0 ] GALLONS GREASE INTERCEPTOR CAPACITY EbMIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K I ] GALLONS DOSING TANK CAPACITY I ]GALLONS @I• ]DOSES PER 24 HRS #Pumps [ 7
D I 225 sQmm FEET Trench configuration drain SYSTEM -
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: Ix] STANDARD I I FILLED E MOUND
I CONFIGURATION: Lx] TRENCH
N
F LOCATION OF BENCHMARK: FFE:11.6 NGVD
I ELEVATION OF PROPOSED SYSTEM SITE L 21.6011
E BOTTOM OF DRAINFIELD TO BE
L
D F
0
T
H
E
R
FT I I
POINT
FT 1 I ABOVE � BENCHMARK/REFERENCE POINT
ILL REQUIRED: 1 0.00 1 INCHES Z_ EXCAVATIOI4 REQUIRED: ( 40.001 INCHES
1 -install a 900 gas min. septic tank with an appro _ d.filter.
2. -The licensed contractor installing the system i¢: sponsIe.f0r instalikng the minimum category of tank in accordance
with s. 64E -6.0130M, FAC.
3. Install 225 sf of drainfield In trench configuration "+
4. -Invert elevation of drainfield to be no less than
5. -Bottom of drainfield elevation to be no tessthali'd' AW NGVD. '
6. -This permit includes the abandonment of the existing septic tank. `*THIS PERMIT IS NOT FOR ANY ADDITIONS.
SPECIFICATIONS BY: Barry G Teixeira TITLE: Master Septic Tank Contractor
APPROVED BY: 6-.7 TITLE: Engineering Specialist II Dade CHD
Betsy Lange-03mino
DATE ISSUED: 0412012015 MIRATION DATE: 07/21/2015
DH 4016, 08/09 (Obsoletes all previous e%.tions Vh i:h.iday not be 'Used)
Incorporated: 64E-6.003, FAC Page 1 of 3
v 1.1.4 AP1185332 38958338
0
0
_4=ffIJJNCill=.I_i7irrci=NOWCI klta'A:I=1101'.1Di:AL11`-
STATE OF FLORIDA APPLICATION # AP1185332
DEPARTMENT OF HEALTH PERMIT # 13 -SC -1601083
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT # SE958336
SITE EVALUATION AND SYSTEM SPECIFICATION
APPLICANT: Margarita Pardo
CONTRACTOR / AGENT: All Pro
LOT: 11 h. BLOCK" Z7:
SUBDIVISION:
TO BE COMPLETED BY ENGINEER, mmmmg Dp;PmTMNT ''EMPLOYEE', OR OTSER QUALIFIED PERSON. ENGINEERS MUS'l
PROVIDE REGISTRATION. NUMBER AND SIM AND SEAM :EACH PAZ Or SUBMITTAL. COMPLETE ALL ITEMS.
PROPERTY SIZE CCNFCFaffl TO SITE PLAN: I X ]YES [ ]NO NET USABLE AREA AVAILABLE: 0.21 ACRES
TOTAL ESTnamm SEWAGE FLOW: 300 GALLONS PER DAY / RESIDENC38-TABLE1 OTHER-UWAl 2 1
AUTHORIZED SEWAGE FLOW: 525.02 GALLONS PER DAY 1500 GPD/ACRE OR 1 2500 GPD/ACRE
UNOBSTRUCTED AREA AVAILABLE: 338.00 SQFT UNOBSTRUCTED AREA REQUIlkED. 338.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION: FFE: 11.6 NGVD
ELEVATION OF PROPOSED SYSTEM SITE Ll-im [INCHES rT 1 1 'ABOVE
THE buNnwm SETBACK WHICH CAN BE M1aNTAn= FROM THE PROPOSED SYSTM TO THE FOLLOWING FEATURES
SURFACE WATER FT DITCHES/SWILLES: FT. NORMALLY MET: [ ]YES I ]NO
WELLS: PUBLIC: FT LIMITED USE: PT PRIVATE: PT NON -POTABLE: FT
BUILDING FOUbIWIONS: 5 FT PROPERTY LINES: 5 .. FT POTABLE WATER LINES: 4 FT
SITE SUBJECT TO FREQUENT FLOODING? ]YES [XINO 10 YEAR FLOODING? I ]YES I XINOJ
10 YEAR FLOOD ELEVATION FOR SITE: FT[ MSL SITE ELEVATION: 9.8() FT MSL
SOIL PROFILE INFORMATION SITE 1 -SOIL PROFILE 110'0101RTION SITE 2
USDA SOIL SERIES. Urban land
Munsell INColor Texture
Dept
10YR 412 Sand
o -r.642
10YR 612 Come Sand
12 i'q 72
USDA SOIL SERIES: Urban land
NlunseU #/Color Texture Depth
Y
R 413 Send 0 T01
10YR 711 Coarse Send 14 To 72
OBSERVED WATER TABLE: mans i ABQVE /FMMC.614. kjaSTING GRADE Tx PERCHED
ESTIMATED WET SEASON WATER TART -v ELEVATION: 70 INCHES I AHM maswma GRADE
HIGH WATER TABLE VEGETATION: [ ]YES EXINO MOTTLING: E ]YES (KIND DEPTH: INCHES
SOIL TEXTUMILOADING FUMM FOR SYSTEM SIZING: Smd/0.80 DEPTH OF EXCAVATION: 40 INCHES
DRAINFIELD CONFISUR4TION: IX I TRENCHBED E I OTHER 5SPECIFY)
- iBMARKSvAuDiTiormli CRITERIA
SITE EVALUATED BY:
DR 4015, 08/09 (Obooletes Previous editions which ma'y'-"iftot be used)
?.Ai4Zporat,04: � -64Z-6.001, VAC
AP1186332
DATE: 04/14=15
Page 3 of 4
v 1.0.2
TEIXEIRA, BARRY GEORGE
ALL PRO PLUMBING SEPTIC AND SEWER INC
1930 N.W. 21 TERR
MIAMI FL 33142
Congratulations! With this license you become one of the nearly
one million Floridians licensed by the Department of Business and
Professional Regulation. Our professionals and businesses range
from architects to yacht brokers, from boxers to barbeque restaurants,
and they keep Florida's economy strong.
Every day we work to improve the way we do business in order to
serve you better. For information about our services, please log onto
www.myfloridalicense.com. There you can find more information
about our divisions and the regulations that impact you, subscribe
to department newsletters and learn more about the Department's.
initiatives.
Our mission at the Department is: License Efficiently, Regulate Fairly.
We constantly strive to serve you better so that you can serve your
customers. Thank you for doing business in Florida,
and congratulations on your new license!
DETACH HERE
RICK SCOTT, GOVERNOR
(850) 487-1395
:STATE OF FLORIDA
- -DEPARTMENT OF BUSINESS AND PRQFESSit3NAL,
CFC1
IBINGCONTRACTOFt
loawtS EEITI1 lEa
the
C:ONSTRUCI
txplratlon date At:IF�T 2096 --
TEIXEFfi, IRR GEOtwG�^
-:1-930 N 24 TERf�
tea• ..
ISSUED: 07/03/2014
KEN LAWSON, SECRETARY
EGUCATIf�N.
DISPLAY AS REQUIRED BY LAW SEQ # L1407OWWO984
008147
A� CERTIFICATE-f]liTE{'YYY} —
OF LIABILITY
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THIS cgMeATic lc 1SSUED asia a�A�a r� u�aai�a�t onrty ani s �o i�tiTs eau st�`c�caT>= . Tis —
CEf1'TIFICA7E DOES IAIOTAEFtRMATAWLY OR MEGATWEL.YAMEMD, EXTBIO OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF IMSURANCE DOES NOT CONSTITUTE A COMTRACT BETWEEN THE ISSUING aM RER(S). AUTHORIZED
REPRESENTAIWE OR PRODUCER, AND THE CERTIFICATE HOLUM
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PRODUCER
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(305)541-3810 __ . _ _(} 541-3811— r
215 SW 17th Avenue Sttlte #217�'
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Miami, FL 33135 -
? Phtute (3055) 541-3810 Fax ( ?41 38i 7 — - -- UNDERWRITERS
wtsuRED -----j t R a AT LLOYDS. LONDON
edsu B : MADISON INSURANCE COMPANY
ALL PRO PLUMBING SEPTIC AND SEWER. INC.
ALL PRO SEPTIC & SEWER. INC, ALL PRO INVESTMENT
HOLDINGS, INC T —
COVERAGES -- -
CERTIFtCAiT: IMlEI RE iSION NUMBER:
r THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED SMOW HAVE BEEN WMJWTOTHE INSUREDNAMM ABOVE FOR THE tPOLIC(PER=D '
INDICATED. NOTWITiiSTANDING ANY REOUJIMMU. TERM OR CONDITION OF ANY CONTRACT OR OTHER DO dT WITH RESPECT TO WFACH THG
CERTIFICATE MAY BE ISSUED OR MAY PSITAIN. THE MURANCE AFFORDW BYE POLICUM DESCROW HEREIN IS SUBZCrTOALL THE TIS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICES. LIFTS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS.
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DESCRIPTnDR1 OF OPERATWM 1 LOCATIONS t Va3t=m (attach ACORD 461. AtltlitiMM Remarks 5¢ba&ft ff MW& ttpM Is m 1
Plumbing contractor septic tank cleaner
CERTIFICATE HOLDER
_ — --- -_ - -- — -.._ - — -- CANCELLATION
- I
Miami Shores Village SHOULD ANY CIF THEABO >: DESCRUMP=ucrosEcA gEFOM
THE EXPIRATWN DATE THEREOF. is1011C. WILL BE MJVEFtED IN
Building Department ACCORDANCE WM4 THE PM ICY PROVISHMS.
10050 NE 2 Ave—._---
AUTHORMW REPRESPIMATWE•-- —
Miami Shores, FL 33138 ' ``
United insurance Agendy A {Preskient) Al OD295
019MI-201st ACOR6 CORA R TiOM. AN dgtis reserved.
ACORD 26 (2010105) OF The ACORD name wW dojo are registered marks of ACORD
DIVISION of
rrs EnAronmentat Heatth
Florida Health
Miami -Dade County AOd
OSTDS/Well Dt"flon
11805 SW 261h Street - Miami, FL 33175
0 Inspector 141col-C Date S1 U.1 11 i
Address 01 Ne 10(a St- osTDs # ft [18 5-93
'yLIS� 101