PL-15-852-
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
nspection Number: INSP-232286 Permit Number: PL -4-15-852
Inspection Date: June 25, 2015 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo Inspection Type: Final
Owner: GARCIA, JAVIER Work Classification: Drainfield
Job Address: 10317 N MIAMI Avpniip
Miami Shores, FL 33138 -
Project: <NONE>
Contractor: MR C'S PLUMBING & SEPTIC INC
ou11U111U vGNa1U11VI R V.vmrnents
DRAIN FIELD INSTALLATION
Phone Number (561)305-3464
Parcel Number 1121360130920
Phone: (305)651-7859
Infractio Passed Gomme
INSPECTOR COMMENTS False
Inspector Comments
Passed HRS ON FILE
Failed OIL
Correction S� C
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
For Inspections please call: (305)762-4949
June 24, 2015 Page 1 of 1
1 'S_yS2_
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
APPLICANT: Javier Garoa
AGENT: Mr C"S
PROPERTY ADDRESS: 10317 N miami Ave Miami, FL 33150
LOT: 1213 BLOCK: 123
APPLICATION #:AP�1180516
PERMIT #:13 -SC -1593652
DOCUMENT #:F1997293
DATE PArD:03/16/2015
FEE PAID:200-00
RECEIPT #:13 -PID -2619752
SUBDIVISION: ID#: 11-2136-013-0920
CHECKED [XI ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
FILL / EXCAVATION MATERIAL
1 1 [221
TANK INSTALLATION
1
(011
TANK SIZE 111 90000 [21
1
[021
TANK MATERIAL
1
1031
OUTLET DEVICE
1
1041
MULTI-CHAMBERED 7 / to
1
1051
OUTLET FILTER
1
1061
LEGEND 1 2,
1 1
1071
WATERTIGHT
[ 1
1081
LEVEL
1 1
[091
DEPTH TO LID
DRAINFIELD INSTALLATION
I 1
1101
AREA [1] 300 (2) SQFT
1
(211
DISTRIBUTION BOX HEADER x
I
f121
NUMBER OF DRAINLINES 1 500 2
1
[131
DRAINLINE SEPARATION
1
[141
DRAINLINE SLOPE
1
1151
DEPTH OF COVER
f I
f161
ELEVATION [ / 9SiOr7 IBM 34 20
1 )
[173
SYSTEM LOCATION
f 1
(181
DOSING PUMPS
1
1191
AGGREGATE SIZE
1
[201
AGGREGATE EXCESSIVE FINES
f 1
[211
AGGREGATE DEPTH
FILL / EXCAVATION MATERIAL
1 1 [221
FILL AMOUNT
( 1 f231
FILL TEXTURE
f 1 [24)
EXCAVATION DEPTH
1 [251
AREA REPLACED
1 [261
REPLACEMENT MATERIAL
Comments:
Comments are On page 2.
CONSTRUCTION
FINAL SYSTEM
Of "I""tlonx On f011o-ing pAW)
SETBACKS
1271 SURFACE WATER FT
(281 DITCHES FT
(29) PRIVATE WELLS FT
[301 PUBLIC WELLS FT
[311 IRRIGATION WELLS
[321 POTABLE WATER
(331 BUILDING FOUNDATIONS
(341 PROPERTY LINES
(35) OTHER
FILLED / MOUND SYSTEM
(361 DRAINFIELD COVER
(37) SHOULDERS
(391 SLOPES
[391 STABILIZATION
ADDITIONAL INFORMATION
1 [40) UNOBSTRUCTED AREA
1 (411 STORMWATER RUNOFF
1 (421 ALARMS
1 [431 MAINTENANCE AGREEMENT
1 [443 BUILDING AREA
1 (451 LOCATION CONFORMS WITH SITE PLAN
1461 FINAL SITE GRADING
(471 CONTRACTOR Mr C"s Plb (Mr C"S Plb)
1 [481 OTHER Ppipes - 2 tier)
ABANDONMENT
1 14 51 TAN!r_-PM4gD
1 [50)K CRUS "
76 HL'Q & FILLED
DR 4016, 08/09'Ap,
(obsclstes all previous editions which may not be us Vo
Incorporated; 64E-6.003, FAC 0-
EH 0046ase 4 �'') I •
APJI051t, E101593652
D 04/21/2015
Poo
I "�OCDATE: 21/2015
P. of
Page 2 Of 3
FT
FT
FT
22
FT
FT
ADDITIONAL INFORMATION
1 [40) UNOBSTRUCTED AREA
1 (411 STORMWATER RUNOFF
1 (421 ALARMS
1 [431 MAINTENANCE AGREEMENT
1 [443 BUILDING AREA
1 (451 LOCATION CONFORMS WITH SITE PLAN
1461 FINAL SITE GRADING
(471 CONTRACTOR Mr C"s Plb (Mr C"S Plb)
1 [481 OTHER Ppipes - 2 tier)
ABANDONMENT
1 14 51 TAN!r_-PM4gD
1 [50)K CRUS "
76 HL'Q & FILLED
DR 4016, 08/09'Ap,
(obsclstes all previous editions which may not be us Vo
Incorporated; 64E-6.003, FAC 0-
EH 0046ase 4 �'') I •
APJI051t, E101593652
D 04/21/2015
Poo
I "�OCDATE: 21/2015
P. of
Page 2 Of 3
o
Miami Shores Village
10050 N.E. 2nd Avenue N
Bond Type - Owners Bond
Miami Shores, FL 33138-0000
CCF
Phone: (305)795-2204
Project Address Parcel Number Applicant
10317 N MIAMI Avenue 1121360130920 JAVIER GARCIA
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
JAVIER GARCIA 10317 N MIAMI Avenue (561)305-3464
MIAMI SHORES FL 33138-
10317 N MIAMI Avenue
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
MR C'S PLUMBING & SEPTIC INC (305)651-7859
Type of Work: DRAIN FIELD INSTALLATION
Type of Piping:
Additional Info:
Bond Retum :
Classification: Residential Scanning: 3
Fees Due
Amount
Bond Type - Owners Bond
$500.00
CCF
$2.40
DBPR Fee
$2.25
DCA Fee
$2.25
Education Surcharge
$0.80
Permit Fee
$150.00
Scanning Fee
$9.00
Technology Fee
$3.20
Total:
$669.90
Valuation: $ 3,200.00
Total Sq Feet: 300
Pay Date
Pay Type
Amt Paid
Amt Due
Invoice #
PL -4-15-55172
04/13/2015
Credit Card
$ 50.00
$ 619.90
04/15/2015
Check #: 2743
$ 119.90
$ 500.00
04/15/2015
Check #: 5182
$ 500.00
$ 0.00
Bond #: 2674
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. Futh raze the a -named contractor to do the work stated.
April 15, 2015
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
April 15, 2015
1
Miami Shores Village
EWEI
Building Department APR 3 205
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 2_5
BUILDING Master Permit No� �
PERMIT APPLICATION Sub Permit No.
F-1 BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ]RENEWAL
PLUMBING [] MECHANICAL ❑PUBLIC WORKS ❑ SHOP
CONTRACTOR ❑ CANCELLATION [3DRAWINGS
JOB ADDRESS: (o3l�i 1 � t1% Q►YY11 AVS uC e,
City Miami Shores County Miami Dade Zito: 3V5 V
Folio/Parcel#: 6JPO Is the Building Historically Designated: Yes NO X_
Occupancy Type: Load: Construction Type: Flood Zone: BFE: ' FFE:
OWNER*. Name (Fee Simple Titleholder):,�Q Vi &V"- GG r G C7, Phone#: 603o5- 31 U 1
Address:- � �MM� iu (I cc, v,-% i k\j ex\ Vim,
Cit'` r 1' �• a rS N`bP44 State: Zip: V
Tenant/Lessee Name:
Email: 14U e-mv
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: City: State: Zip:
Value of Work for this Permit: $ ' ou Square/Linear Footage of Work: J
Type of Work: El Addition ❑ A ter on ❑ New Repair/Replace Demolition
Description of Work: 7�•A
Specify color of color thru tile: Submittal Fee $ Permit Fee $J�o
Senning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
CCF $ CO/CC $
DBPR $ Notary It
Double Fee $
Bond -t
Structural Reviews $
TOTAL FEE NOW DUE $
(Revised02/24/2014) G 1 9 � 9
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
Zip
City State 'vy 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 $25W, 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.
Signature Signature
WNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
1 3 day of NO 120 15- • by
y iGr- %rGi who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
The foregoing instrument was acknowledged before me this
_ dayrof , 20 (r . by
K G T, lfl�L�t. . who is personally known to
as me or who has produced
Identification and who did take an oath.
NOTARY PUBLIC:
as
APPROVED BY '15 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
REPAIR
PERMIT #:13 -SC -1593652
WAMI-aAM COUNTY HEALTH Dr --p ,TIoN #: API 18051A
STATE OF FLORIDA
DEPARTMENT OF HEALTH DATE Pte:
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID:
CONSTRUCTION PERMIT
RECEIPT #
PR967998
OSTDS Repair
APPLICANT: Javier Garcia
PROPERTY ADDRESS: 10317 N miami Ave Miami, FL 33150
LOT: 12 13 BLOCK: 123 SUBDIVISION:
PROPERTY ID #: 11-2136-013-0920
[SECTION, TOR NSHIP, RANGE, PARCEL ]
[OR TAX ID NUMBER]
SYSTEM MOST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
38110065, 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 MODIFICATICNS 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 I 0 l GALLONS / GPD CAPACITY
N I 0 1 GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMaM CAPACITY SINGLE TANK:1250 GALLONS]
K I ] GALLONS DWING TANK CAPACITY [ ]GALLONS 0( ]DOSES PER 24 HRS #Pu3mps [
D I 300 1 SQUARE FEET new bed confsf. drainfield SYSTEM
R [ 0 I SQUARE FEET SYSTEM
A TYPE SYSTEM: [X] STANDARD [ ) FILLED [ I MOUND [ ]
I CONFIGURATION: [ ] TRENCH IXl BED [ ]
N
F LOCATION OF BENCHMARK: FFE 12.9' NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 21.601[ FT ) I ABOVE't� BENCHMARK/REFERENCE POINT
E BoTTabd OF DRAINFIELD TO BE 171.64 1 [INCHES FT 7 I ABOVE iL RzNCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: C 62.00] INCHES
1. -Existing 900 gal. septic tank, certified by "Mr.C's Plumbing" on 3/16/2015 to remain.
O 2.4nstall 300 sf of drainfield in bed configuration.
T 3. -Install 12" of slightly limiter soil at the bottom of the drainfield.
H 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.)
E
R I
SPECIFICATIONS BY:
APPROVED BY:
DATE ISSUED:
TITLE:
TITLE: Engineering Specialist II Dade CHD
DH 4016,08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
EXPIRATION DATE: 06/16/2015
V i.i a pp Th ion« aJ paasab' �, sEgSgasS 71
.. _ parethe reat
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